Brain dysfunction evaluation system, brain dysfunction evaluation method, and program

ABSTRACT

A system for evaluating a degree of brain dysfunction of a subject, such as a decline in cognitive function, calculates a difference in movement functions between both hands in a coordination movement. The system includes a storage device for storing time-series data on a finger movement task of each of both hands of a test subject acquired by a movement sensor; a data processing device for analyzing the time-series data stored in the storage device; and a display device for displaying an analysis result analyzed by the data processing device. The data processing device includes a movement waveform generation unit for generating a movement waveform corresponding to the time-series data stored in the storage device; and a difference-between-hands feature quantity generation unit for generating a difference-between-hands feature quantity which represents a difference in respective finger movement tasks between both hands, based on the respective movement waveforms of both hands.

CROSS REFERENCE TO RELATED APPLICATION

This application is a Continuation of U.S. patent application Ser. No.15/507,020 filed on Feb. 27, 2017 which is a National Stage Applicationof PCT/JP2015/066997, filed on Jun. 12, 2015, which claims priority ofJapanese Patent Application No. 2014-176434 filed on Aug. 29, 2014,which are incorporated herein by reference.

TECHNICAL FIELD

The present invention relates to a technique of evaluating a degree ofbrain dysfunction such as a decline in cognitive function.

BACKGROUND ART

With a progress of aging society, the number of cases of dementia isincreasing these years. The number of dementia patients in Japan iscurrently estimated at as many as about two millions. Dementia may causememory difficulty, disorientation, learning disorder, and the like,which interfere with everyday activities. In some cases, symptomsinclude behavioral problems such as verbal abuse, aggressive behavior,wandering, and filthy behavior. In a late stage of dementia, the patientmay have movement disorder such as walking in short steps and having adroopy posture, and eventually becomes bedridden.

There are three main types of dementia: Alzheimer's disease,cerebrovascular dementia, and Lewy body dementia. In other types ofdementia, cognitive impairment sometimes occurs with movement disorderassociated with Parkinson's disease or the like and mental disorderassociated with depression, schizophrenia, or the like. Only after adefinitive diagnosis of which type of dementia a patient has is made,appropriate therapy adapted to the diagnosed type can be provided suchas medication treatment. Development of any types of dementia can becontrolled keeping it at a stage of mild cognitive impairment, if thedisease is diagnosed at an early stage and appropriate medication isadministered. There is thus a need for a screening test of detectingdementia early, targeting healthy elderly people who are more likely todevelop dementia.

Major dementia diagnostic measures are tests of cognitive functionsincluding memory and judgment, such as Hasegawa's dementia scale andMMSE (Mini Mental State Examination). Those diagnostic measures require,however, that a medical doctor conducts a face-to-face test for severalto several tens of minutes. From a viewpoint of restriction in time,those measures may not be suited for a screening test for a large numberof test subjects.

Another diagnostic measure is a diagnosis by means of brain imagemeasurement, which includes: a technique of examining whether or notthere is brain shrinkage using CT (Computed Tomography) or MRI (MagneticResonance Imaging); and a technique of detecting how much amyloid betawhich is considered to cause dementia is accumulated, using SPECT(Single Photon Emission Computed Tomography) or PET (Positron EmissionTomography). The brain image measurement described above requires,however, a high test fee and a long test time. The above-describedmeasure may not be thus suited for a screening test for a large numberof test subjects.

Besides the cognitive function test and the brain image measurementdescribed above, findings are that measurement of hand finger movementcan detect a decline in cognitive function. It is thought in generalthat cognitive impairment makes it difficult to perform cooperativemovement of four limbs or body movement in response to externalstimulus. Such a decreased function in body movement is likely to beobserved especially in a hand finger which conducts a movement with highdexterity, even in an early stage. Dementia is thus likely to bedetected in an early stage, based on a result of measurement of thefinger movement using electronic equipment or the like.

Some related arts such as, for example, Patent Document 1, PatentDocument 2, Patent Document 3, and Non-Patent Document 1 disclose anevaluation system for assessing cognitive function of a test subject ina simplified manner without depending on a medical doctor. Theevaluation system uses a device capable of easily measuring fingermovement, such as a button press device, a tablet computer, and amagnetic sensor. Patent Document 4 proposes a technique of representinga decline in cognitive function, by evaluating a phase difference infinger-to-thumb tapping (repeated opening and closing movement of twofingers (a thumb and an index finger, for example)) of each of bothhands.

RELATED ART DOCUMENT Patent Documents

-   Patent Document 1: Japanese Laid-Open Patent Application,    Publication No. 2012-217797-   Patent Document 2: Japanese Laid-Open Patent Application,    Publication No. 2011-083403-   Patent Document 3: Japanese Laid-Open Patent Application,    Publication No. 2008-246126-   Patent Document 4: Japanese Laid-Open Patent Application,    Publication No. 2007-301003

Non-Patent Document

-   Non-Patent Document 1: Robbins T. W. et al., “Cambridge    Neuropsychological Test Automated Battery (CANTAB): a factor    analytic study of a large sample of normal elderly volunteers”,    Dementia and Geriatric Cognitive Disorders, Switzerland, 1994, Vol.    5, No. 5, pp. 266-281

SUMMARY OF THE INVENTION Problems to be Solved by the Invention

As a decline in cognitive function progresses, a difference in movementfunctions between both hands is considered to become larger. Thus, amethod of calculating a difference in movement functions between bothhands is effective in evaluating cognitive impairment. In this regard,the techniques disclosed in Patent Document 1, Patent Document 2, PatentDocument 3, and Non-Patent Document 1 describe measurement of a fingermovement task with one hand. As will be understood, those Documents failto evaluate a difference in movement functions between both hands.Patent Document 4 proposes the technique of evaluating a phasedifference in finger-to-thumb tapping between both hands. PatentDocument 4, however, fails to explicitly calculate a difference inmovement functions between both hands, which cannot achieve theabove-described method.

In light of the described above, the present invention has been made inan attempt to easily evaluate a degree of brain dysfunction such as adecline in brain dysfunction, by calculating a difference in movementfunctions between both hands when a subject performs a both handscoordination movement.

Means for Solving the Problem

In order to solve the problems, the present invention has been made inan attempt to provide: a brain dysfunction evaluation system, including:a storage unit configured to store therein time-series data on a fingermovement task of each of both hands of a test subject, the time-seriesdata being acquired by a movement sensor; an analysis unit configured toanalyze the time-series data stored in the storage unit; and a displayunit configured to display an analysis result analyzed by the analysisunit. The analysis unit includes: a movement waveform generation unitconfigured to generate a movement waveform corresponding to thetime-series data stored in the storage unit; and adifference-between-hands feature quantity generation unit configured togenerate a difference-between-hands feature quantity which represents adifference in respective finger movement tasks between both hands of thetest subject, based on the generated respective movement waveforms ofboth hands.

Other means for solving the problems will be described hereinafter.

Effects of the Present Invention

The present invention makes it possible to easily evaluate a degree ofbrain dysfunction such as a decline in cognitive function, bycalculating a difference in movement functions between both hands in aboth hands coordination movement.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a block diagram illustrating an entire configuration of abrain dysfunction evaluation system according to an embodiment of thepresent invention.

FIG. 2 is a diagram illustrating a diagram illustrating how a movementsensor is attached to a hand of a subject.

FIG. 3 is a diagram illustrating a configuration of a movement sensorcontroller.

FIG. 4 is a diagram illustrating a movement waveform.

FIGS. 5A and 5B are a table illustrating a plurality of featurequantities acquired from the movement waveform.

FIG. 6 is an explanatory diagram illustrating definition of terms offinger-to-thumb tapping.

FIG. 7A is an explanatory diagram illustrating a zero crossing count ofa velocity waveform. FIG. 7B is an explanatory diagram illustrating azero crossing count of an acceleration waveform.

FIG. 8 is an explanatory diagram illustrating a local standard deviationof amplitude of a distance waveform.

FIG. 9A is an explanatory diagram illustrating skewness of a frequencydistribution of tap intervals. FIG. 9B is an explanatory diagramillustrating a near-local-maximal-point peakedness of a distancewaveform.

FIGS. 10A and 10B are explanatory diagrams illustrating trajectories inchaotic time series analyses. FIG. 10A is each a diagram illustrating atrajectory of a healthy elderly subject. FIG. 10B is each a diagramillustrating a trajectory of a dementia patient.

FIGS. 11A and 11B are diagrams illustrating significance probabilitieswhen t-test is applied to difference-between-hands feature quantities ofa healthy elderly subject group and a dementia patient group. FIG. 11Ais the diagram when both hands synchronized finger tapping wasperformed. FIG. 11B is the diagram when both hands alternating fingertapping was performed.

FIG. 12A is an explanatory diagram illustrating a variation cycle of adifference-in-both-hands waveform. FIG. 12B is an explanatory diagramillustrating a frequency peak of the difference-in-both-hands waveform.

FIG. 13 is a diagram illustrating a test subject information entryscreen.

FIG. 14 is a diagram illustrating a measurement screen.

FIG. 15 is a block diagram illustrating another configuration of a braindysfunction evaluation system including a terminal device and a serveraccording to a variation of the present invention.

EMBODIMENTS FOR CARRYING OUT THE INVENTION

An embodiment for carrying out the present invention (which ishereinafter referred to as an embodiment) is described in detail belowwith reference to related drawings.

In this embodiment to be described below, the terms “brain dysfunction”collectively refer to all those may cause a decline in so-calledcognitive function (for example, Alzheimer's disease, cerebrovasculardementia, Lewy body dementia, Parkinson's disease, hydrocephalus,depression, and schizophrenia), which also includes movement disordercaused by cerebral apoplexy or the like. To simplify explanation in theembodiment, the brain dysfunction may also be referred to as dementia.

[Entire Configuration]

As illustrated in FIG. 1 , a brain dysfunction evaluation system 1000according to this embodiment includes: a movement function measurementdevice 1100 configured to measure a hand finger movement task performedby a subject; a brain dysfunction evaluation apparatus 1200 configuredto store and analyze data measured by the movement function measurementdevice 1100; an operation input device 1300 configured to receive aninput of information on a test subject or the like; and a display device1400 (which may also be referred to as a display unit) configured tooutput a result of the measurement or the analysis and display theoutputted data.

The test subject herein is a subject who is subjected to a measurementby the movement function measurement device 1100. In this embodiment,the test subject is an individual who wants to take a test on whether ornot he/she has developed dementia or how severe is his/her disease.

The movement function measurement device 1100 measures movements of handfingers of the test subject, when the test subject carries out a fingermovement task. The finger movement task used herein includes:finger-to-thumb tapping (in which the subject repeatedly opens andcloses a thumb and an index finger of his/her hands as quickly andwidely as possible) measured by a magnetic sensor; and a movement oftouching or sliding a screen on a tablet terminal equipped with a touchpanel sensor (a touch screen type sensor). The finger movement task usedhereinafter means the finger-to-thumb tapping.

[Motor Function Measurement Device]

The movement function measurement device 1100 detects information on afinger movement task of a test subject (which may also be simplyreferred to as “movement information”) in time series. The movementfunction measurement device 1100 acquires movement information on atleast one of a distance, a velocity, an acceleration, a jerk (which isobtained by temporally differentiating the acceleration) of the testsubject as time-series data (waveform data).

The movement function measurement device 1100 includes a movement sensor1110, a movement sensor interface 1120, and a movement sensor controldevice 1130.

The movement sensor interface 1120 and the movement sensor controldevice 1130 are accommodated in an accommodating device 1500, which is asingle body, in this embodiment. Alternatively, the devices 1120, 1130may not be accommodated in the single body.

<<Movement Sensor>>

As illustrated in FIG. 2 , the movement sensor 1110 includes: atransmitting coil 2100 which generates a magnetic field; and a receivercoil 2200 which receives (detects) the magnetic field.

The transmitting coil 2100 and the receiver coil 2200 are attached to anail of a thumb and a nail of an index finger using, for example, adouble faced adhesive tape, respectively. Alternatively, thetransmitting coil 2100 and the receiver coil 2200 may be attached to thenail of the index finger and the nail of the thumb, respectively.

In this embodiment, the transmitting coil 2100 and the receiver coil2200 are attached to the nails of the thumb and the index finger,respectively, or vice versa. The embodiment is not, however, limited tothis. The coils 2100, 2200 may be attached to, for example, the fingersother than the nails.

The coils 2100, 2200 may be attached to, not limited to the thumb andthe index finger, but to the thumb and a finger other than the indexfinger, for example, the thumb and a little finger. Parts to which thecoils 2100, 2200 are attached are not limited to the nails or fingers ofthe test subject, but to, for example, parts neighboring the fingerssuch as a palm near the fingers. The transmitting coil 2100 and thereceiver coil 2200 are thus attached to any of the nails, the fingers,and the parts neighboring the fingers of the test subject, as long asthe finger movement task can be detected.

<<Movement Sensor Interface>>

The movement sensor interface 1120 (see FIG. 1 ): includes an analog todigital converter circuit; and is configured to convert waveform data ofan analog signal detected by the movement sensor 1110, into waveformdata of a digital signal with a predetermined sampling frequency, andintroduces the converted digital signal into the movement sensor controldevice 1130 (see FIG. 1 ).

<<Movement Sensor Control Device>>

FIG. 3 is a block diagram illustrating a configuration of the movementsensor control device 1130 (wherein the movement sensor interface 1120is not shown). Next is described how the movement sensor control device1130 acquires waveform data.

In FIG. 3 , an alternative current (AC) generating circuit 3100generates an AC voltage having a specific frequency (for example, 20kHz). A current generating amplifier circuit 3200 converts the ACvoltage having the specific frequency generated by the AC generatingcircuit 3100, into an alternating current having a specific frequency.The converted alternating current flows to the transmitting coil 2100. Amagnetic field generated by the alternating current running in thetransmitting coil 2100 makes the receiver coil 2200 generate an inducedelectromotive force.

The induced electromotive force generates another alternating current inthe receiver coil 2200 (which has a frequency same as that of the ACvoltage with the specific frequency generated by the AC generatingcircuit 3100). A pre-amplifier circuit 3300 amplifies the generatedalternating current, of which signal after the amplification is inputtedin a detector circuit 3400. The detector circuit 3400 detects the signalafter the amplification, by the specific frequency generated by the ACgenerating circuit 3100 or a double frequency thereof. That is, avariation corresponding to fluctuations in voltage caused by a change indistance between the two fingers is extracted from a waveform containinga high frequency. For this purpose, a phase adjustment circuit 3600:adjusts a phase of the output of the AC generating circuit 3100; andintroduces the adjusted output into a reference signal input terminal ofthe detector circuit 3400 as a reference signal 3700.

An output signal of the detector circuit 3400 passes through a LPF(Low-Pass Filter) circuit 3500 for removing a high frequency component;is amplified by the amplifier circuit 3800 so as to obtain a desiredvoltage; and is introduced in the brain dysfunction evaluation apparatus1200. An output signal 3900 from the amplifier circuit 3800 indicates avoltage value corresponding to a relative distance D between thetransmitting coil 2100 and the receiver coil 2200 attached to the thumband the index finger, respectively (a conversion formula from therelative distance into the voltage value will be described hereinafter).

Description above has been made assuming a case where the movementsensor 1110 is a magnetic sensor. Alternatively, the movement sensor1110 may be an acceleration sensor, a strain gauge, a high-speed camera,or the like. Or, a finger movement task may be measured by touching orsliding a screen on a tablet terminal, a smartphone, or the like, withone or more fingers.

[Brain Dysfunction Evaluation Apparatus]

The brain dysfunction evaluation apparatus 1200 (see FIG. 1 ) isconfigured to store and analyze data measured by the movement functionmeasurement device 1100. The brain dysfunction evaluation apparatus 1200used herein includes: a data input device 1210 configured to receive anoutput signal (time-series data) from the movement sensor control device1130; a data processing device 1220 (which may also be referred to as ananalysis unit) configured to analyze the output signal having beeninputted; a signal control unit 1230 configured to transmit a signal formaking the movement function measurement device 1100 start ameasurement; a test subject information processing unit 1240; an outputprocessing unit 1250 configured to process a result analyzed by the dataprocessing device 1220, into a form such that the result can beoutputted to the display device 1400; a storage device 1260 (which mayalso be referred to as a storage unit) configured to store therein dataprocessed by the data processing device 1220 and the test subjectinformation processing unit 1240; and a controller 1270 configured tocontrol data transmission and reception, arithmetic processing, or thelike.

<<Data Processing Device>>

The data processing device 1220 (see FIG. 1 ) calculates (generates) amovement waveform of a finger-to-thumb tapping performed by a testsubject, based on the output signal transmitted from the data inputdevice 1210 and received via the controller 1270; and thereby calculatesan objective index representing how severe is a dementia of the testsubject. The information obtained as described above is stored in thestorage device 1260 where appropriate.

The data processing device 1220 includes: a movement waveform generationunit 1221; and a difference-between-hands feature quantity generationunit 1222.

<Movement Waveform Generation Unit>

The movement waveform generation unit 1221 (see FIG. 1 ) convertstime-series data (waveform data) of the voltage output transmitted fromthe movement function measurement device 1100, into an appropriatemovement waveform; temporally differentiates or integrates the convertedmovement waveform; and thereby complementarily generates a distancewaveform, a velocity waveform, and an acceleration waveform (details ofwhich will be described later).

The conversion formula for converting the voltage output (a voltagevalue) into the movement waveform (a relative distance waveform or thelike) can be given as an approximate curve. The approximate curve isobtained as follows, for example. The test subject holds a calibrationblock with his/her two fingers. The calibration block is prepared bycombining a plurality of blocks having different lengths (for example,blocks having 20, 30, and 60 mm in length) into one unit. Each time thetest subject holds different parts having the different lengths (forexample, 20, 30, and 60 mm) of the block, a voltage value and a distancevalue are measured. The approximate curve is calculated as a curve whichminimizes a difference between a data set of the voltage value and thedistance value, and an error thereof.

FIG. 4 is a diagram illustrating: a distance waveform 4100 which isobtained by converting the waveform data using the conversion formula; avelocity waveform 4200 which is obtained by temporally differentiatingthe distance waveform 4100; and an acceleration waveform 4300 which isobtained by temporally differentiating the velocity waveform 4200. Theterm “movement waveform” used herein includes, unless otherwise limited,at least one of a distance waveform, a velocity waveform, anacceleration waveform, and a jerk waveform. Note that even when a straingauge, an acceleration meter, or the like is used as the movementfunction measurement device 1100, measurement of at least one of themovement waveforms (of distance, velocity, acceleration, and jerk) makesit possible to complementarily obtain the other movement waveforms bymeans of differentiation or integration.

<Difference-Between-Hands Feature Quantity Generation Unit>

The difference-between-hands feature quantity generation unit 1222 (seeFIG. 1 ) is configured to generate a difference-between-hands featurequantity which is a difference in respective finger movement tasksbetween the left and right hands, based on the movement waveformobtained from the movement waveform generation unit 1221. In thisembodiment, the difference-between-hands feature quantity can becalculated in two different ways. One is that: respective featurequantities based on the movement waveforms of the left and right handsare separately calculated; and a difference between the two featurequantities are calculated (which may also be referred to as a firstdifference-between-hands feature quantity calculation method). The otheris that: a time-series data which corresponds to a difference in themovement waveforms between the left and right hands; and calculates afeature quantity with respect to the difference waveform (which may alsobe referred to as a second difference-between-hands feature quantitycalculation method). Next are described the two ways described above.

(First Difference-Between-Hands Feature Quantity Calculation Method)

[Feature Quantity Calculated Based on Movement Waveform of One Hand]

FIGS. 5A and 5B are a diagram illustrating names and definitions offeature quantities. Below are explained in detail some technical termsand feature quantities having feature quantities Nos. 5023 to 5029.Feature quantities having feature quantity Nos. 5001 to 5022 are asdefined in FIGS. 5A and 5B, detailed description of which is thusomitted herefrom. Note that the terms “a feature quantity having afeature quantity No. 50XX” may also be simply referred to as “a featurequantity 50XX”.

As illustrated in FIG. 6 , a period 6100 of finger-to-thumb tapping isdefined as a time period from when a distance value crosses an averagevalue 6200 of a distance waveform during a time period during which thedistance waveform is measured, and at the same time, a velocity issmaller than 0, till when the same conditions are satisfied next time. Atap interval is defined as a length of the period. A point at which thedistance value is the smallest in the period is referred to as a localminimum point 6300 of the distance waveform. The distance value at thepoint is referred to as a local minimal value. Similarly, a point atwhich the distance value is the largest in the period is referred to asa local maximum point 6400 of the distance waveform. The distance valueat the point is referred to as a local maximal value. A movementstarting from the local minimum point of a distance waveform until anext local maximal point thereof is defined as an opening movement 6500.A movement starting from the local maximal point of the distancewaveform till a next local minimum point thereof is defined as a closingmovement 6600.

A zero crossing count of a velocity waveform 5023 (or a feature quantity5023; hereinafter the same, and names of the other feature quantitiesmay also be represented similarly) (see FIG. 5B) is a value obtained bysubtracting the tapping count 5019, from the number of times a velocitychanges from a positive value to a negative value during a measurementtime. Herein, the number of times the velocity changes from the positivevalue to the negative value may be substituted by the number of timesthe velocity changes from the negative value to the positive value.

The zero crossing count of the velocity waveform 5023 is a featurequantity for counting the number of times of up-and-down vibrations 7100as illustrated in the distance waveform of FIG. 7A, other than largemovements contained in the finger-to-thumb tapping. The count thevelocity waveform crosses “0” corresponds to the number of times of theup-and-down vibrations of the distance waveform. A dementia patient hasin general a larger number of times of such up-and-down vibrations in adistance waveform than that of a healthy subject.

Similarly, a zero crossing count of an acceleration waveform 5024 (seeFIG. 5B) is a value obtained by subtracting the tapping count 5019, fromthe number of times an acceleration changes from a positive value to anegative value during a measurement time. Herein, the number of timesthe acceleration changes from the positive value to the negative valuemay be substituted by the number of times the acceleration changes fromthe negative value to the positive value.

As illustrated in FIG. 7B, the zero crossing count of the accelerationwaveform 5024 is a feature quantity for counting not only theup-and-down vibrations but also a part 7200 at which strength ofmomentum unnaturally fluctuates in a middle of the finger-to-thumbtapping. The count the acceleration waveform crosses “0” corresponds tothe number of times of unnatural fluctuations in the momentum strengthof the distance waveform. A dementia patient has in general a largernumber of times of such unnatural fluctuations in the momentum strengththan that of a healthy subject.

A local standard deviation of local maximal values of a distancewaveform 5025 (see FIG. 5B) is, as illustrated in FIG. 8 , an averagevalue of standard deviations of local maximal values situated in “n”distances of the distance waveform (standard deviations of local maximalvalues of respective distances of distance waveforms for consecutive “n”periods), through the entire measurement time. Any number can be used as“n”, as long as it is an integer of two or more and is smaller than thetapping count.

A local standard deviation of tap intervals 5026 (a feature quantity ondispersion of tapping time intervals) (see FIG. 5B) is an average valueof standard deviations of neighboring “n” tap intervals through theentire measurement time. Any number can be used as “n”, as long as it isan integer of two or more and is smaller than the tapping count.

It is contemplated that local vibrations in amplitude are large indementia or similar diseases through the entire measurement time.Meanwhile, the local vibrations in amplitude of a healthy subject arenot significant, though the amplitude gradually becomes smaller throughthe entire measurement time as the healthy subject becomes tired. Astandard deviation of local maximal values of a distance waveform 5005is obtained by calculating the standard deviations through the entiremeasurement time, which makes it difficult to show a difference betweena dementia patient and a healthy individual. In contrast, the localstandard deviation of local maximal values of a distance waveform 5025can represent the difference therebetween, because local standarddeviations continuously calculated through the entire measurement timeshow local variations in amplitude. Similarly, a local standarddeviation of tap intervals 5026 can represent a difference therebetween.

Skewness of tap interval distribution 5027 (a feature quantity ondispersion of tapping time intervals) (see FIG. 5B) is skewness of afrequency distribution 9100 (a histogram) of tap intervals during theentire measurement time as illustrated in FIG. 9A. The skewness usedherein is a statistical indicator representing asymmetry of adistribution, and can be obtained by, for example, dividing an averageof a cube of a deviation (a difference from an average value) by a cubeof a standard deviation.

A frequency distribution of tap intervals of a healthy individual isconsidered to take a shape close to a normal distribution. The frequencydistribution of a dementia or similar disease patient may sometimes havea long tap interval. This makes the frequency distribution take a shapewith a wider bottom toward a horizontal axis positive direction (on aright side of a horizontal axis in FIG. 9A). Distribution skewness oftap intervals 5027 can represent a property as described above. That is,it is contemplated that skewness of the frequency distribution of thehealthy individual is close to “0”, and that of the dementia patienttakes a relatively large value.

A near-local-maximal-point peakedness 5028 (see FIG. 5B) is an averagevalue of peakednesses of local maximal points of the distance waveformthrough the entire measurement time. The peakedness used herein is astatistical indicator representing a degree of how sharp a distributioncurve is. The peakedness can be obtained by, for example, dividing anaverage of the fourth power of deviations (differences from respectiveaverage values) by the fourth power of standard deviations. Asillustrated in FIG. 9B, the peakedness is herein calculated assumingthat a distance waveform having a certain value (for example, 55 mm) ormore is taken as a near-local-maximal-point distance waveform 9200.

The near-local-maximal-point peakedness 5028 is considered to representmuscle stiffness (muscle rigidity). Stiff muscle may cause not a smoothbut an abrupt switching between an opening movement and a closingmovement, making a distance waveform near a local maximal point sharp.

[Trajectory of Chaotic Time Series]

Stability of time delay trajectory 5029 (see FIG. 5B) used herein is, asillustrated in FIGS. 10A and 10B, a value (a feature quantity)representing stability of a trajectory 10100 of Movement waveform X(t)at Time t and Movement waveform X(t+k) at Time t+k. The trajectory isgenerated by plotting a finger-to-thumb tapping with X(t) and X(t+k) onhorizontal and vertical axes, respectively (time delay k is apredetermined constant value, for example, 20 msec or the like). Thetrajectory plotting described above is used in a field of chaotic timeseries analysis for evaluating periodicity or stability of time-seriesdata. Stability of finger-to-thumb tapping can be evaluated based on aform of the trajectory. The trajectory of X(t) and X(t+k) 10100 of ahealthy elderly subject draws ellipses inclined upward right withrespect to both a dominant hand and a nondominant hand, and demonstratesstability in any period (see FIG. 10A). The trajectory of a dementiapatient with respect to a dominant hand also draws ellipses, indicatingstability. The trajectory of the dementia patient with respect to anondominant hand is, however, indicative of instability (see FIG. 10B).

The stability of time delay trajectory 5029 (a feature quantity) forevaluating stability is obtained by calculating an area of a differencebetween a trajectory for each period and an innermost trajectory andcalculating an average value thereof. The larger the stability of timedelay trajectory 5029, the less stable the periods of finger-to-thumbtapping during the measurement time. Note that the trajectory as anattractor is herein drawn with the two axes, X(t) and X(t+k). Thetrajectory may be drawn with three or more axes, such as X(t), X(t+k),and X(t+2k).

In the feature quantities having the feature quantity Nos. 5001 to 5029illustrated in FIGS. 5A and 5B, instead of the standard deviation,another statistical indicator showing data variability such asdispersion may be used. In order to equalize data on subjects' handsdifferent in size, the data may be standardized using a distance valuewhen the two fingers of interest are extended as wide as possible.

[Difference-Between-Hands Feature Quantity]

The feature quantities 5001 to 5029 of the finger-to-thumb tapping foreach of the dominant hand and the nondominant hand are calculated. Afeature quantity of the dominant hand is then subtracted from a featurequantity of the nondominant hand, which is referred to as adifference-between-hands feature quantity. As a decline in cognitivefunction progresses, a difference in movement functions between thedominant hand and the nondominant hand is considered to become larger.On the other hand, the dominant hand and the nondominant hand areconsidered to reflect inherent physical capability of a test subject.The difference-between-hands feature quantity can thus indicate howsevere a decline in cognitive function is, after the inherent physicalcapability of the test subject is offset.

FIGS. 11A and 11B illustrate significance probabilities which indicatewhether or not there is a significant difference indifference-between-hands feature quantities between a healthy elderlysubject and a dementia patient. As illustrated in FIG. 11A, in bothhands synchronized finger tapping (finger tapping in which the fingersof both hands are opened and closed simultaneously) with respect to thestandard deviation of tap intervals (the feature quantity 5022) (whichis a feature quantity on variations of tapping time intervals) and alocal standard deviation of tap intervals (the feature quantity 5026), adifference-between-hands feature quantity has a smaller significanceprobability than a feature quantity of each of the nondominant hand andthe dominant hand, meaning that there is a significant difference (thesignificance probability p<0.05). As illustrated in FIG. 11B, in bothhands alternating finger tapping (finger tapping in which the fingers ofboth hands are opened and closed), with respect to the zero crossingcount of a velocity waveform (the feature quantity 5023), adifference-between-hands feature quantity has a smaller significanceprobability than a feature quantity of the nondominant hand and thedominant hand, meaning that there is a significant difference(significance probability p<0.05).

When the difference-between-hands feature quantity of the featurequantities 5001 to 5029 are calculated, instead of subtracting thefeature quantity of the dominant hand from the feature quantity of thenondominant hand, the feature quantity of the nondominant hand may besubtracted from the feature quantity of the dominant hand. Or, thefeature quantity of the nondominant hand may be divided by the featurequantity of the dominant hand, and vice versa. That is, respectivefeature quantities of both hands are used for obtaining a difference (asubtraction value in which one value is subtracted from another) or aquotient value obtained by dividing one value by another, which allowsdifference-between-hands feature quantity to be calculated.

(Second Difference-Between-Hands Feature Quantity Calculation Method)

Next is described an example of how to calculate a feature quantityafter a difference in movement waveforms between both hands iscalculated, as a second difference-between-hands feature quantitycalculation method.

[Variation Cycles of Nondominant Hand and Dominant Hand]

An ideal finger-to-thumb tapping task with both hands opening andclosing simultaneously (both hands synchronized finger tapping) has nodisplacement in respective waveforms of both hands. It is easy for ahealthy subject to simultaneously move his/her both hands withoutdisplacement. Even if any displacement is generated, the subject canpromptly adjust his/her movement so as to eliminate the displacement. Itis difficult, however, for a dementia patient presenting with aprogressive decline in cognitive function to move both hands insynchronization. It is also difficult to recognize and eliminatedisplacement, if any.

FIG. 12A illustrates a difference-in-both-hands waveform 12100 which isobtained by calculating a difference in respective movement waveforms(time-series data) between both hands. The difference-in-both-handswaveform 12100 always takes a value “0”, if there is no displacementbetween the waveforms of both hands. Meanwhile, thedifference-in-both-hands waveform 12100 takes a large value, if there islarge displacement. The difference-in-both-hands waveform 12100 containstwo types of frequencies: a first frequency which is same as that offinger-to-thumb tapping (about 2 to about 5 Hz for a healthyindividual); and a second frequency as a variation cycle 12200 foreliminating displacement between both hands.

FIG. 12B illustrates a frequency spectrum (frequency component) 12300which is calculated by applying Fourier transform to thedifference-in-both-hands waveform. Respective frequencies correspondingto the two strongest peak values of the frequency spectrum 12300 areextracted and taken as a first frequency 12400 and a second frequency12500 (a difference-between-hands feature quantity) which is smallerthan the first frequency 12400. The larger the second frequency 12500,the more quickly the displacement is eliminated and the smaller adecline in cognitive function. In other words, it can be determined thatthe decline in cognitive function is large, if, for example, the secondfrequency 12500 is not more than a prescribed threshold (for example,about 1 Hz).

<<Signal Control Unit>>

The signal control unit 1230 (see FIG. 1 ) transmits a signal forstarting a measurement to the movement function measurement device 1100in response to an operation signal transmitted from the operation inputdevice 1300. The movement function measurement device 1100 is in standbystate when no measurement is performed, and enters a state ready formeasurement on receipt for the signal from the signal control unit 1230.

<<Test Subject Information Processing Unit>>

The test subject information processing unit 1240 (see FIG. 1 ) managesinformation, using a test subject DB (Data Base) of the storage device1260 which stores therein test subject information or information onanalysis results.

More specifically, the test subject information processing unit 1240performs four major processings as follows, making use of the testsubject DB: 1) register, modify, delete, search, and sort the testsubject information; 2) associate the test subject information withmeasurement data; 3) register, modify, and delete a result of analysisof the measurement data (add, modify, and delete an appropriate item);and 4) if statistical processing is performed, register, modify, anddelete a result of the statistical processing.

The test subject information registered in the test subject DB includes:a test subject ID (Identifier), a name, a birth date, an age, a bodyheight, a body weight, a disease name, and comments on the test subject.Note that information management performed by the test subjectinformation processing unit 1240 can be easily realized using knownprogram and data configuration.

<<Output Processing Unit>>

The output processing unit 1250 (see FIG. 1 ) makes the display device1400 display the test subject information registered in the test subjectDB or information on the analysis result or the like in a display styleeasy to visually understand, using an appropriate graph or table format.The output processing unit 1250 may or may not simultaneously displayall of the analysis result described above, and may display only an itemselected by an operator via the operation input device 1300.

<<Controller>>

The controller 1270 (see FIG. 1 ) includes a CPU (Central ProcessingUnit), a ROM (Read Only Memory), a RAM (Random Access Memory), or thelike.

Respective functions of the units in the data processing device 1220,the signal control unit 1230, the test subject information processingunit 1240, and the output processing unit 1250 are realized by loadingappropriate programs or data stored in the storage device 1260, into thecontroller 1270, and by executing an arithmetic processing.

[Operation Input Device]

The operation input device 1300 (see FIG. 1 ) is configured to receivean entry of the test subject information by an operator of the braindysfunction evaluation system 1000; and can be realized by means of akeyboard, a mouse, or the like. An entry screen may be displayed in adisplay as a user interface for assisting the operator in entering thetest subject information.

[Display Device]

The display device 1400 (see FIG. 1 ) is configured to output the testsubject information or movement information processed by the dataprocessing device 1220, and can be realized by, for example, a LCD(Liquid Crystal Display), a CRT (Cathode Ray Tube) display, a printer,or the like.

(Example of Screen)

Next is described an example of a screen displayed in the display device1400 with reference to FIG. 13 and FIG. 14 .

As illustrated in FIG. 13 , an entry screen of the test subjectinformation includes a test subject ID entry field 13100, a name entryfield 13200, a birth date entry field 13300, a handedness entry field13400, and a remarks entry field 13500. A measurer (for example, amedical doctor) enters appropriate information in those entry fields andclicks a save button 13600 with a mouse, in response to which the testsubject information processing unit 1240 stores the entered test subjectinformation in the storage device 1260. Information on handedness isused for calculation performed by the difference-between-hands featurequantity generation unit 1222.

When a measurer (for example, a medical doctor) clicks a measurementexecution button 14100 on the measurement screen for displaying amovement waveform under measurement, as illustrated in FIG. 14 , themeasurement is started and a movement waveform 14300 under measurementis drawn. When the measurer clicks a save button 14200 after completionof the measurement, the movement waveform and a result of analysisobtained by the respective units of the data processing device 1220 aresaved.

Advantageous Effects

The brain dysfunction evaluation system 1000 according to thisembodiment can evaluate a degree of severity of dementia using adifference-between-hands feature quantity calculated by thedifference-between-hands feature quantity generation unit 1222.

In this embodiment, a program to be executed by a computer constitutingthe brain dysfunction evaluation system 1000 can be created andinstalled in the computer. This allows the computer to realize variousfunctions based on the program.

(Variation)

Next is described a variation of the brain dysfunction evaluation system1000.

[Variation of Configuration of Brain Dysfunction Evaluation System]

FIG. 15 is a diagram illustrating an example of an entire configurationof a brain dysfunction evaluation system 1000 a according to a variationof the present invention. The brain dysfunction evaluation system 1000 aillustrated in FIG. 15 realizes functions substantially same as those ofthe brain dysfunction evaluation system 1000 illustrated in FIG. 1 , butperforms the functions separately with a terminal device 15100 and aserver 15200 which are connected each other via a communication network15300.

In the brain dysfunction evaluation system 1000 a, the terminal device15100: presents a movement task to a test subject; and acquires data onthe movement task of the test subject. The server 15200: receives thedata on the movement task of the test subject acquired by the terminaldevice 15100, via the communication network 15300; and evaluates howsevere a decline in cognitive function of the test subject is, based onthe data on the movement task of the test subject. Except the describedabove, the configuration and the functions of the brain dysfunctionevaluation system 1000 a are same as those of the brain dysfunctionevaluation system 1000 illustrated in FIG. 1 , description of which isthus focused on only those different from each other.

The terminal device 15100 includes a communication device 15400 (whichmay also be referred to as a first communication device) connected tothe communication network 15300, in addition to the movement functionmeasurement device 1100 of the brain dysfunction evaluation system 1000illustrated in FIG. 1 . The server 15200 includes a communication device15500 (which may also be referred to as a second communication device)connected to the communication network 15300, in addition to the braindysfunction evaluation system 1000 illustrated in FIG. 1 , the braindysfunction evaluation apparatus 1200, the operation input device 1300,and the display device 1400. Information transmitted from thecommunication device 15400 to the communication device 15500 via thecommunication network 15300 is time-series data of a movement waveformor the like.

The terminal device 15100 having the configuration as described abovecan be realized by a personal computer, a tablet terminal, a smartphone,or the like of a medical doctor, a test subject, a caregiver thereof, orthe like. The server 15200 can be realized by a high-performancepersonal computer, a work station, a general-purpose computer, or thelike. Note that one unit of the server 15200 may be connected to aplurality of the terminal devices 15100 via the communication network15300.

In the brain dysfunction evaluation system 1000 a, the terminal device15100 simply acquires data on a movement task of a test subject. Thismeans that if by any chance, the terminal device 15100 is lost, data ona degree of cognitive impairment of a test subject is prevented fromleaking. Further, a result of evaluating the cognitive impairment or thelike of the test subject can be stored in the storage device 1260 of theserver 15200. This means that a medical doctor, a nurse, a caregiver,and the others concerned can have an easy access to the result. Theserver 15200 in the brain dysfunction evaluation system 1000 a allows aneasy connection to a system which manages another medical and healthinformation, such as an electronic health record system, a medicationrecord system, and a healthcare system.

The present embodiments have been explained as above. The presentinvention is not, however, limited to the above-described embodimentsbut includes different kinds of variations. For example, theabove-described embodiments are intended to be illustrative of thepresent invention in an easily understandable manner and the presentinvention is not limited to the one that includes all of the componentsexplained in the embodiments. Part of a configuration of an embodimentof the present invention can be substituted by that of anotherembodiment. Part or all of a configuration of an embodiment of thepresent invention can be added to that of another embodiment. Further,various changes in specific configurations and processings are possiblewithin a scope not departing from the gist of the present invention.

The invention claimed is:
 1. A finger movement evaluation system,comprising: one or more movement sensors configured detectfinger-to-thumb tapping with both hands opening and closingsimultaneously of a test subject; a memory configured to store thereintime-series data on the finger-to-thumb tapping acquired by the movementsensor; a data processor configured to analyze the time-series datastored in the memory; and a display configured to display an analysisresult analyzed by the data processor, wherein the data processorconfigured to: based on the time-series data stored in the memory,generate a movement waveform of each of both hands of the test subject,each corresponding to the time-series data; based on the generatedmovement waveform of each of both hands of the test subject, generate adifference-in-both-hands waveform which is a difference between therespective movement waveforms of both hands, thedifference-in-both-hands waveform containing a first frequency which isa frequency of the finger-to-thumb tapping and a second frequency whichis a frequency as a variation cycle for eliminating displacement betweenboth hands; and based on the generated difference-in-both-handswaveform, generate a difference-between-hands feature quantity.
 2. Thefinger movement evaluation system according to claim 1, wherein the dataprocessor is configured to: calculate a frequency spectrum by applyingFourier transform to the difference-in-both-hands waveform; anddetermine, as the difference-between-hands feature quantity, a smallerfrequency selected from respective frequencies corresponding to each oftwo strongest peak values of the calculated frequency spectrum.
 3. Afinger movement evaluation system, comprising: a terminal device thatcomprises one or more movement sensors configured to detectfinger-to-thumb tapping with both hands opening and closingsimultaneously of a test subject, and a first communication device; anda server that comprises a second communication device configured tocommunicate with the terminal device, a memory configured to storetherein time-series data on the finger-to-thumb tapping, which isacquired from the movement sensor via the second communication device, adata processor configured to analyze the time-series data stored in thememory, and a display configured to display an analysis result analyzedby the data processor, wherein the data processor of the server isfurther configured to: based on the time-series data stored in thememory, generate a movement waveform of each of both hands of the testsubject, each corresponding to the time-series data; based on thegenerated movement waveform of each of both hands of the test subject,generate a difference-in-both-hands waveform which is a differencebetween the respective movement waveforms of both hands, thedifference-in-both-hands waveform containing a first frequency which isa frequency of the finger-to-thumb tapping and a second frequency whichis a frequency as a variation cycle for eliminating displacement betweenboth hands; and based on the generated difference-in-both-handswaveform, generate a difference-between-hands feature quantity.
 4. Afinger movement evaluation method using a finger movement evaluationsystem that comprises: one or more movement sensors configured to detectfinger-to-thumb tapping with both hands opening and closingsimultaneously of a test subject; a memory configured to store thereintime-series data on the finger-to-thumb tapping, which is acquired bythe movement sensor; a data processor configured to analyze thetime-series data stored in the memory; and a display configured todisplay an analysis result analyzed by the data processor, the fingermovement evaluation method comprising: a step of generating, by the dataprocessor, based on the time-series data stored in the memory, amovement waveform of each of both hands of the test subject, eachcorresponding to the time-series data; a step of generating, by the dataprocessor, based on the generated movement waveform of each of bothhands of the test subject, a feature quantity of each of both hands; astep of generating, by the data processor, based on the generatedmovement waveform of each of both hands of the test subject, adifference-in-both-hands waveform which is a difference between therespective movement waveforms of both hands, thedifference-in-both-hands waveform containing a first frequency which isa frequency of the finger-to-thumb tapping and a second frequency whichis a frequency as a variation cycle for eliminating displacement betweenboth hands; and a step of generating a difference-between-hands featurequantity, by the data processor, based on the generateddifference-in-both-hands waveform.
 5. The finger movement evaluationmethod according to claim 4, wherein, under control of the dataprocessor, a frequency spectrum is calculated by applying Fouriertransform to the difference-in-both-hands waveform, and a smallerfrequency selected from respective frequencies corresponding to each oftwo strongest peak values of the calculated frequency spectrum isdetermined as the difference-between-hands feature quantity.